Posterolateral uterine rupture in scarred uterus complicated by external iliac vein injury

Posterolateral uterine rupture in scarred uterus complicated by external iliac vein injury

Youssef M Zohdy1, Ziad M Ahmed2

1Faculty of Medicine, Alexandria University, Egypt; 2Department of Obstetrics and Gynaecology, Faculty of Medicine, Alexandria University, Egypt

Uterine wall rupture is a rare yet catastrophic complication of pregnancy with a high mortality rate of both the mother and the fetus. The condition could be classified according to etiology into primary unscarred uterus, and secondary scarred uterus or according to the site of rupture. Our case presented with scarred uterine rupture through a posterolateral injury. The patient had history of 3 previous CS and a D&C procedure. The rupture was complicated by EIV injury. Uterine rupture does not always present with profound manifestations of shock especially in posterior wall rupture and timely management ensures the best possible outcome. Finally, meticulous examination of the anatomically related structures and vessels, and the repair of any associated injuries, is essential.

Keywords: D&C, EIV injury, Uterine rupture

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Youssef M Zohdy, Ziad M Ahmed. Posterolateral uterine rupture in scarred uterus complicated by external iliac vein injury. International Journal of Case Reports, 2021, 5:238. DOI: 10.28933/ijcr-2021-08-0505


1. Cunningham F. In Obstetrical hemorrhage and prior caesarean delivery, Cunningham FG, Leveno KJ, Bloom SL, Spong CY, Dashe JS, Hoffman BL et al (eds.), William’s Obstetrics, 24th ed, by McGraw-Hill Education; 2014;790-793: 609-20.
2. Sayed Ahmed WA, Habash YH, Hamdy MA, Ghoneim HM. Rupture of the pregnant uterus – a 20-year review. J Matern Neonatal Med. 2017;30(12):1488–93. DOI: 10.1080/14767058.2016.1219997
3. Al-Zirqi I, Stray-Pedersen B, Forsen L, Daltveit A-K, Vangen S. Uterine rupture: trends over 40 years. BJOG 2016;123(5):780-7. DOI: 10.1111/1471-0528.13394
4. Gupta B, Bhagat PK, Karim R. Rupture uterus: a one year review to find out the causative factors. Int J Reprod Contraception, Obstet Gynecol. 2020;9(8):3249-52. DOI:
5. Hasanzadeh M, Dadgar S, Arian Y, Yousefi Y. Angular ectopic pregnancy presenting as rupture of lateral wall of the uterus: Late presentation in gestation week 20. Iran J Med Sci. 2017;42(3):314–7.
6. Singhal SR, Agarwal U, Sangwan K, Khosla A, Singhal S. Intrapartum posterior uterine wall rupture in lower segment cesarean section scarred uterus. Acta Obstet Gynecol Scand. 2005;84(2):196–7. DOI:
7. Wang LM, Wang PH, Chen CL, Au HK, Yen YK, Liu WM. Uterine preservation in a woman with spontaneous uterine rupture secondary to placenta percreta on the posterior wall: a case report. J Obstet Gynaecol Res. 2009;35(2):379–84. DOI: 10.1111/j.1447-0756.2008.00936.x
8. Wang PH, Yuan CC, Chao HT, Yang MJ, Ng HT. Posterior uterine wall rupture during labour. Hum Reprod. 2000;15(5):1198–9. DOI: 10.1093/humrep/15.5.1198
9. Majumdar S, Warren R, Ifaturoti O. Fetal survival following posterior uterine wall rupture during labour with intact previous caesarean section scar. Arch Gynecol Obstet. 2007;276(5):537–40. DOI: 10.1007/s00404-007-0365-x
10. Chen SH, Du XP. Silent spontaneous posterior uterine rupture of a prior caesarean delivery at 36 weeks of gestation. BMC Pregnancy Childbirth. 2019;19(1):23. DOI: 10.1186/s12884-019-2180-3
11. Figueroa R, Garry D, Mackenzie AP. Posterior uterine rupture in a woman with a previous Cesarean delivery. J Matern Neonatal Med. 2003;14(2):130–1. DOI: 10.1080/jmf.
12. Abbas AM, Michael A, Nagy M. A rare case of posterior uterine rupture with neonatal survival during trial of vaginal birth after cesarean section. Proc Obstet Gynecol. 2017;7(3):1–6.
13. Navaratnam K, Ulaganathan P, Akhtar MA, Sharma SD, Davies MG. Posterior Uterine Rupture Causing Fetal Expulsion into the Abdominal Cavity: A Rare Case of Neonatal Survival. Case Rep Obstet Gynecol. 2011;2011:426127. DOI: 10.1155/2011/426127
14. Hawe JA, Olah KS. Posterior uterine rupture in a patient with a lower segment caesarean section scar complicating prostaglandin induction of labour. BJOG An Int J Obstet Gynaecol. 1997;104(7):857–8. DOI: 10.1111/j.1471-0528.1997.tb12037.x
15. Roberts M, Nordin AJ. Posterior uterine rupture in a patient with a lower segment Caesarean section scar complicating prostaglandin induction of labour. Br J Obstet Gynaecol 1997;104(12):1421. DOI: 10.1111/j.1471-0528.1997.tb11021.x
16. Oppenheimer DC, Mazaheri P, Ballard DH, Yano M, Fowler KJ. Magnetic resonance imaging of the placenta and gravid uterus: a pictorial essay. Abdom Radiol (NY). 2019 Feb;44(2):669-84. DOI: 10.1007/s00261-018-1755-1

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